TY - JOUR T1 - Pathophysiologic Correlation Between <sup>62</sup>Cu-ATSM and <sup>18</sup>F-FDG in Lung Cancer JF - Journal of Nuclear Medicine JO - J Nucl Med SP - 1948 LP - 1953 DO - 10.2967/jnumed.109.069021 VL - 50 IS - 12 AU - Talakad Goolaiah Lohith AU - Takashi Kudo AU - Yoshiki Demura AU - Yukihiro Umeda AU - Yasushi Kiyono AU - Yasuhisa Fujibayashi AU - Hidehiko Okazawa Y1 - 2009/12/01 UR - http://jnm.snmjournals.org/content/50/12/1948.abstract N2 - The purpose of this study was to delineate the differences in intratumoral uptake and tracer distribution of 62Cu-diacetyl-bis(N4-methylthiosemicarbazone) (62Cu-ATSM), a well-known hypoxic imaging tracer, and 18F-FDG in patients with lung cancer of pathohistologically different types. Methods: Eight patients with squamous cell carcinoma (SCC) and 5 with adenocarcinoma underwent 62Cu-ATSM and 18F-FDG PET within a 1-wk interval. For 62Cu-ATSM PET, 10-min static data acquisition was started at 10 min after a 370- to 740-MBq tracer injection. After image reconstruction, 62Cu-ATSM and 18F-FDG images were coregistered, and multiple small regions of interest were drawn on tumor lesions of the 2 images to obtain standardized uptake values (SUVs). The regression lines were determined between SUVs for 62Cu-ATSM and 18F-FDG in each tumor. The slope values were compared between SCC and adenocarcinoma to observe pathohistologic differences in intratumoral distribution of the tracers. Results: SUVs for 62Cu-ATSM were lower than those for 18F-FDG in both SCC and adenocarcinoma. SCC tumors showed high 62Cu-ATSM and low 18F-FDG uptakes in the peripheral region of tumors but low 62Cu-ATSM and high 18F-FDG uptakes toward the center (spatial mismatching). The relationship of SUVs for the 2 tracers was negatively correlated with a mean regression slope of −0.07 ± 0.05. On the other hand, adenocarcinoma tumors had a spatially similar distribution of 62Cu-ATSM and 18F-FDG, with positive regression slopes averaging 0.24 ± 0.13. The regression slopes for 62Cu-ATSM and 18F-FDG differed significantly between SCC and adenocarcinoma (P &lt; 0.001). Conclusion: The intratumoral distribution patterns of 62Cu-ATSM and 18F-FDG were different between SCC and adenocarcinoma in lung cancers, indicating that intratumoral regions of high glucose metabolism and hypoxia could differ with the pathohistologic type of lung cancer. The identification of regional biologic characteristics in tumors such as hypoxia, energy metabolism, and proliferation could play a significant role in the clinical diagnosis and therapy planning for non–small cell lung cancer patients. ER -